OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Certification Regarding Rights to Unemployment Benefits

OMB 3220-0079 · RRB.

OMB 3220-0079

In administering the disqualification for the voluntary leaving of work provision of Section 4 of the Railroad Unemployment Insurance Act, the Railroad Retirement Board investigates an unemployment claim that indicates the claimant left voluntarily. The certification obtains information needed to determine if the leaving was for good cause.

The latest form for Certification Regarding Rights to Unemployment Benefits expires 2026-10-31 and is listed under ICR 202308-3220-003.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form UI-45 (11-16) Certification Regarding Rights to Unemployment BenefitsForm
3220-0079 .docxSupporting Statement A
Form UI-1 (03-12).pdf Supplementary Document
Form UI-3 (02-09).pdf Supplementary Document
Chapter 315.pdf Supplementary Document
Form UI-33 (12-05).pdf Supplementary Document
Certification Regarding Rights to Unemployment Benefits Form

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202308-3220-003 Extension without change of a currently approved collection 2023-09-05 Approved without change
202005-3220-001 Extension without change of a currently approved collection 2020-05-22 Approved without change
201702-3220-002 Extension without change of a currently approved collection 2017-03-10 Approved without change
201312-3220-001 Extension without change of a currently approved collection 2014-02-28 Approved without change
201011-3220-002 Extension without change of a currently approved collection 2010-11-29 Approved without change
200708-3220-002 Extension without change of a currently approved collection 2007-08-28 Approved without change
200407-3220-001 Revision of a currently approved collection 2004-07-06 Approved without change
200107-3220-001 Extension without change of a currently approved collection 2001-07-16 Approved without change
199806-3220-001 Revision of a currently approved collection 1998-06-24 Approved without change
199504-3220-001 Revision of a currently approved collection 1995-04-14 Approved without change
199202-3220-002 Revision of a currently approved collection 1992-02-13 Approved without change
198904-3220-012 No material or nonsubstantive change to a currently approved collection 1989-04-10 Approved with change
198904-3220-003 No material or nonsubstantive change to a currently approved collection 1989-04-03 Approved with change
198812-3220-002 Revision of a currently approved collection 1988-12-27 Approved without change
198802-3220-001 Extension without change of a currently approved collection 1988-02-02 Approved without change
198412-3220-002 Revision of a currently approved collection 1984-12-19 Approved without change
198111-3220-002 Extension without change of a currently approved collection 1981-11-17 Approved without change
198105-3220-017 No material or nonsubstantive change to a currently approved collection 1981-05-28 Approved with change
198103-3220-033 No material or nonsubstantive change to a currently approved collection 1981-03-21 Approved with change
198102-3220-011 Reinstatement with change of a previously approved collection 1981-02-19 Approved without change
197912-3220-004 Revision of a currently approved collection 1979-12-27 Approved without change
197410-3220-004 Extension without change of a currently approved collection 1974-10-29 Approved without change